Even Short-term Oral Steroid Side Effects Are Bad News!

Oral steroids (e.g., prednisolone, hydrocortisone, methylprednisolone (medrol) dosepak, etc.) are prescribed often, most commonly for inflammatory conditions, such as arthritis, bronchitis and asthma, inflammatory bowel diseases, muscle pain, allergies, and more. I have known for a long time about the complications and side effects associated with the long-term use of oral steroids (osteoporosis, weight gain, behavior changes, increase in blood pressure, etc.), so the general recommendation has been to take the minimum dose necessary for the shortest amount of time needed to treat the problem; however, a new study suggests I and my patients also have good reason to be concerned about short-term oral steroid side effects as well, even at fairly low doses.

Before I discuss the newest study, let’s review some other concerns I’ve addressed on this blog regarding oral steroids.

Oral Steroids Are Bad News

I’ve said it before, and I’ll say it again: steroids are bad news. While I’ve discussed the boatload of problems uncovered in studies on epidural steroids, I’ve also devoted a fair share to oral steroid side effects as well. Though most of the studies, until now, have focused on the complications of long-term steroid use.

I recognize, of course, that there are certain serious conditions, such as asthma, for example, in which steroids like a prednisone inhaler are prescribed and absolutely necessary; however, the concern here are those oral steroids prescribed for much less life-threatening conditions, such as a simple upper respiratory infection, a flare up of sciatica, and even arthritis (see the alternatives section below). If for some reason you and your doctor feel you need to take oral steroids for a minor short-term problem, You may want to consider taking vitamin E, which has been shown to lower osteonecrosis risk in animal studies!

New Study Shows Fractures and Embolisms and Sepsis, Oh My!

The new study included over 1.5 million adults and compared those who were taking a short-term prescription of oral steroids (defined by this study as 30 days or less) to those who were not taking steroids. Six days was the median duration of time subjects used the steroids, with 47% taking the heavily prescribed six-day Medrol (methylprednisolone) dosepak. Study authors concluded there was a significant increased risk for fractures, blood clots, and sepsis (a severe life-threatening infection) in the subjects who had short-term use of oral steroids, even at lower doses, compared to subjects who had not taken the drug.

How much did these risks go up?

-Sepsis by 530%

-Blood clot by 333%

-Fracture by 187%,

But are there alternatives? Yes, for example, for most patients who take a short course of oral steroids for sciatica, they can either be managed by oral anti-inflammatory supplements or a targeted epidural at the problem area using their own growth factors.

The upshot? The biggest take home message here is that even a short course of oral steroids like a Medrol dosepak can dramatically increase the risk for life changing side effects. Given how frequently these things are prescribed (usually by family physicians), there are likely thousands of cases of preventable fractures, blood clots, and sepsis every year. Our biggest issue is what I call the “Internal Medicine” mentality, meaning that some physicians aren’t trained how to diagnose where a musculoskeletal problem originates, so they just throw medications at it. Hopefully, physicians who prescribe these medications for simple things like a pinched nerve will now think twice.

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Years ago I was taking Enbrel for RA primarily in my hands and it was working. Then I developed Afib and congestive heart failure. I had to have heart ablation and they wouldn’t put me back on Enbrel suspecting it was a causative factor in my heart problems. I am a health nut and have taken the best of antiinflamatory supplements but only prednisone 5mg twice daily works. If I don’t take it regularly I get a bad attack (terrible shakes, chills, severe pain in hands, neck, upper arm – I can’t function. I have followed your blogs for some time and would like to get some treatment and eventually get off prednisone. Isn’t there anything you can do to help me? Eileen Miller healthsense-gnld@msn.com

Chris Centeno, M.D. is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. Centeno regularly lectures on regenerative medicine and has spoken twice at the Vatican Stem Cell Conference, as well as the NFL Combine.

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*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. All patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

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*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.